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MYCO WELL D-ONE detection of Ureaplasma spp. and Mycoplasma hominis in sexual health patients in Wales. Eur J Clin Microbiol Infect Dis 2020; 39:2427-2440. [PMID: 32725499 PMCID: PMC7669805 DOI: 10.1007/s10096-020-03993-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/20/2020] [Indexed: 10/26/2022]
Abstract
The genital mycoplasmas are a unique group of inherently antibiotic-resistant sexually transmitted bacteria, often associated with non-gonococcal urethritis and bacterial vaginosis. The MYCO WELL D-ONE is a culture-based assay that aims to detect these organisms whilst concurrently screening them for antibiotic resistance. Urine and/or swabs from 856 informed and consented participants attending Welsh sexual health clinics were subjected to MYCO WELL D-ONE analysis, alongside qPCR and culture titration methodologies to determine sensitivity, specificity, PPV, NPV and accuracy. Resistance was confirmed by CLSI-compliant susceptibility testing and genetic mechanisms determined. The MYCO WELL D-ONE displayed a sensitivity and specificity of 91.98% and 96.44% for the detection of Ureaplasma spp., with sensitivity and specificity values of 78.23% and 98.84% for Mycoplasma hominis, compared with qPCR. Swabs harboured significantly greater bacterial loads than urine samples for both Ureaplasma spp. and M. hominis. Levofloxacin resistance rates, mediated by Ser83Leu mutation in ParC, for Ureaplasma spp. were 0.54%. Tetracycline resistance rates, mediated by tet(M), were 0.54% and 2% for Ureaplasma spp. and M. hominis, respectively; sequence analysis of tet(M)-positive Ureaplasma spp. and M. hominis strains isolated from a single individual confirmed separate resistance gene origins. The MYCO WELL D-ONE is a sensitive and specific assay for the detection of Ureaplasma spp. and M. hominis in genitourinary medicine samples, facilitating the accurate detection of these organisms within low-technology environments. While good for antibiotic resistance screening, accurate confirmation by MIC determination or molecular methods are required, and more optimally performed on urine samples.
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Vijayan V, Woods GL, Donnell DR, Romero JR. Pelvic Abscess Secondary to Mycoplasma Hominis after Vaginal Laceration. J Pediatr Adolesc Gynecol 2018; 31:146-148. [PMID: 28838864 DOI: 10.1016/j.jpag.2017.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/08/2017] [Accepted: 08/12/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mycoplasma hominis frequently colonizes the urogenital and respiratory tracts of healthy individuals. It has also been associated with genitourinary tract and extragenital syndromes. CASE We present a 14-year-old girl who developed a pelvic abscess secondary to M. hominis after a vaginal laceration during sexual intercourse. Despite drainage and broad-spectrum antimicrobial therapy, the patient remained symptomatic until M. hominis was identified and specific therapy instituted. SUMMARY AND CONCLUSION Health care providers need to be aware of the potential for M. hominis as a causal agent in patients who present with pelvic abscesses after vaginal trauma. This case highlights the challenges that exist in the diagnosis and treatment of M. hominis, because bacterial cultures are often negative and empiric antimicrobial agents do not provide adequate antimicrobial coverage.
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Affiliation(s)
- Vini Vijayan
- Section of Infectious Diseases, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | - Gail L Woods
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Dale R Donnell
- Department of Microbiology, Arkansas Children's Hospital, Little Rock, Arkansas
| | - José R Romero
- Section of Infectious Diseases, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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3
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Maraki S, Mavromanolaki VE, Nioti E, Stafylaki D, Minadakis G. Prevalence and antimicrobial susceptibility of Ureaplasma species and Mycoplasma hominis in Greek female outpatients, 2012-2016. J Chemother 2017; 30:140-144. [PMID: 29182058 DOI: 10.1080/1120009x.2017.1404287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Mycoplasma hominis and Ureaplasma species are opportunistic pathogens associated with urogenital infections, complications during pregnancy and postpartum infections. Appropriate empirical antimicrobial treatment is necessary to achieve an optimal therapeutic outcome. This study evaluated the prevalence and the antimicrobial susceptibility of Mycoplasma hominis and Ureaplasma spp. isolated from 1,008 endocervical samples of outpatients in Crete, Greece, during a five-year period (2012-2016), using the commercially available Mycoview kit (Zeakon diagnostics, France). Ureaplasma spp. was isolated from 116 patients (11.5%), M. hominis from 6 (0.6%), while coinfection with both mycoplasmas was demonstrated in 17 (1.7%). All Ureaplasma strains were susceptible to josamycin and doxycycline. Doxycycline, minocycline and ofloxacin were the most potent antibiotics against M. hominis. Docycycline was proved the most active and is still the drug of choice for the treatment of genital mycoplasma infections. Local surveillance to monitor changes in antimicrobial susceptibilities is necessary to guide treatment strategies.
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Affiliation(s)
- Sofia Maraki
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
| | | | - Eleni Nioti
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
| | - Dimitra Stafylaki
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
| | - George Minadakis
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
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4
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Gerovassili A, Marcandona O, Asimakopoulos B, Karavasilis V, Panopoulou M, Ikonomidis A. Relationship between Chlamydia-Ureaplasma-Mycoplasma Genital Detection with Semen Concentration and Motility among Greek Men. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2017; 11:130-133. [PMID: 28670432 PMCID: PMC5347451 DOI: 10.22074/ijfs.2017.4690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 09/08/2016] [Indexed: 11/04/2022]
Abstract
One hundred and seventy two men at the State of Thessaly, Greece, inquiring semen analysis were enrolled in the study in order to investigate the incidence of Chlamydia, Ureaplasma and Mycoplasma (C-U-M) genera in respect to total sperm number (TSN), progressive motility (grades a and b) and total motility (grades a, b and c). Putative relation of C-U-M acquirement with sexual behavior was also investigated. Incidence of C-U-M among non-oligozoospermic and oligozoospermic men was similar. Νο correlation of C-U-M carriage to either oligozoospermia or asthenozoospermia was found. The tested semen parameters were negatively correlated to the age of sexual intercourse initiation and positively correlated to the number of sex partners. Early age of sexual intercourse initiation or high number of sexual partners was not statistical significantly correlated to C-U-M acquirement. Overall, TSN and motility (either progressive or total) were not influenced by the presence of C-U-M genera in a sample of Greek population undergoing semen evaluation. To distinguish the role of C-U-M in male infertility and clarify the so far controversial scarce literature, large control case studies are needed using nucleic acid amplification techniques to detect these pathogens.
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Affiliation(s)
- Ageliki Gerovassili
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - Ourania Marcandona
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - Byron Asimakopoulos
- Democritus University of Thrace, Laboratory of Physiology, Alexandroupolis, Greece
| | | | - Maria Panopoulou
- Democritus University of Thrace, Department of Microbiology, Alexandroupolis, Greece
| | - Alexandros Ikonomidis
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece.,Democritus University of Thrace, Department of Microbiology, Alexandroupolis, Greece
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5
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Abbott CE, Greene RE, Kapadia F, Halkitis PN. A Case of Rectal Ureaplasma Infection and Implications for Testing in Young Men Who Have Sex with Men: The P18 Cohort Study. LGBT Health 2016; 4:161-163. [PMID: 28027001 DOI: 10.1089/lgbt.2016.0030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ureaplasma is a significant cause of nongonococcal urethritis. This is a case of rectal Ureaplasma found on culture in a young man who has sex with men not previously reported in the literature. Nucleic acid amplification tests are now standard of care for sexually transmitted infection testing, but they do not test for Ureaplasma and, therefore, may be missing important infections. Ureaplasma could have important implications in urethritis and rectal HIV transmission among men who have sex with men engaging in condomless anal intercourse. Further study of Ureaplasma's role as a rectal pathogen may be warranted.
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Affiliation(s)
| | - Richard E Greene
- 2 Department of Internal Medicine, New York University School of Medicine , New York, New York.,3 Center for Health, Identity, Behavior and Prevention Studies, New York University , New York, New York
| | - Farzana Kapadia
- 3 Center for Health, Identity, Behavior and Prevention Studies, New York University , New York, New York.,4 College of Global Public Health, New York University , New York, New York.,5 Department of Population Health, New York University School of Medicine, New York, New York
| | - Perry N Halkitis
- 3 Center for Health, Identity, Behavior and Prevention Studies, New York University , New York, New York.,4 College of Global Public Health, New York University , New York, New York.,5 Department of Population Health, New York University School of Medicine, New York, New York
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Payne MS, Ireland DJ, Watts R, Nathan EA, Furfaro LL, Kemp MW, Keelan JA, Newnham JP. Ureaplasma parvum genotype, combined vaginal colonisation with Candida albicans, and spontaneous preterm birth in an Australian cohort of pregnant women. BMC Pregnancy Childbirth 2016; 16:312. [PMID: 27756249 PMCID: PMC5070304 DOI: 10.1186/s12884-016-1110-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 10/11/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Detection of Ureaplasma, Mycoplasma and Candida spp. in the vagina during pregnancy has previously been associated with preterm birth (PTB). However, the prevalence of these microorganisms and the associated obstetric risks (likely to be population-specific) have not been determined in Australian women; furthermore, in the case of Ureaplasma spp., very few studies have attempted characterisation at the species level and none have examined genotype/serovar status to further refine risk assessment. METHODS In order to address these issues we sampled the vaginal fluid of 191 pregnant Australian women at three time points in pregnancy. Culture methods were used for detection of Ureaplasma spp. and Candida spp., and real-time PCR was used for speciation of U. parvum and U. urealyticum, non-albicans Candida spp., Mycoplasma hominis and Mycoplasma genitalium. High-resolution melt PCR was used to genotype U. parvum. Data on various lifestyle factors (including sex during pregnancy and smoking), antimicrobial use and pregnancy outcome were collected on all participants. Chi-square tests were used to assess the association of vaginal microorganisms with PTB. RESULTS Detection of Ureaplasma spp. was higher among spontaneous PTB cases, specifically in the presence of U. parvum [77 % preterm (95 % confidence interval (CI) 50-100 %) vs. 36 % term (CI: 29-43 %), p = 0.004], but not U. urealyticum. The association with PTB strengthened when U. parvum genotype SV6 was detected (54 % preterm (CI: 22-85 %) vs. 15 % term (CI: 10-20 %), p = 0.002); this genotype was also present in 80 % (4/5) of cases of PTB <34 weeks gestation. When present with Candida albicans in the same sample, the association with PTB remained strong for both U. parvum [46 % preterm (CI: 15-78 %) vs. 13 % term (CI: 8-18 %), p = 0.005] and U. parvum genotype SV6 [39 % preterm (CI: 8-69 %) vs. 7 % term (CI: 3-11 %), p = 0.003]. With the exception of Candida glabrata, vaginal colonisation status for all organisms was stable throughout pregnancy. Smoking significantly increased the likelihood of detection of all target organisms. CONCLUSIONS These data suggest that the presence of different species and serovars of Ureaplasma spp. in the vagina confers an increased risk of spontaneous PTB, findings which may be useful in risk assessment for identifying women who would benefit from antimicrobial treatment.
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Affiliation(s)
- Matthew S. Payne
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
| | - Demelza J. Ireland
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
| | - Rory Watts
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
| | - Elizabeth A. Nathan
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
- Women and Infants Research Foundation, Biostatistics and Research Design Unit, Subiaco, WA 6008 Australia
| | - Lucy L. Furfaro
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
| | - Matthew W. Kemp
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
| | - Jeffrey A. Keelan
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
| | - John P. Newnham
- School of Women’s and Infants’ Health, University of Western Australia, 2nd Floor, Block A, King Edward Memorial Hospital, Subiaco, WA 6008 Australia
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Ikonomidis A, Venetis C, Georgantzis D, Giaslakiotis V, Kolovos V, Efstathiou K, Moschou M, Κoutsiaris Ε, Panopoulou M. Prevalence of Chlamydia trachomatis, Ureaplasma spp., Mycoplasma genitalium and Mycoplasma hominis among outpatients in central Greece: absence of tetracycline resistance gene tet(M) over a 4-year period study. New Microbes New Infect 2015; 9:8-10. [PMID: 26862428 PMCID: PMC4706606 DOI: 10.1016/j.nmni.2015.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/04/2015] [Accepted: 11/04/2015] [Indexed: 10/30/2022] Open
Abstract
A total of 301 men and women attending local urologists and gynaecologists in the state of Thessaly, central Greece, were tested for Chlamydia trachomatis, Ureaplasma spp., Mycoplasma genitalium and Mycoplasma hominis DNA. Investigation of the tet(M) gene, which confers tetracycline resistance in these genera, was also performed. Low incidence of C. trachomatis and Mycoplasma spp. as well as high prevalence of Ureaplasma spp., especially among women, were found. The tet(M) gene was absent in all cases, notably in a region where doxycycline administration remains the first therapeutic option unless special medical conditions direct otherwise.
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Affiliation(s)
- A Ikonomidis
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece; Democritus University of Thrace, Department of Microbiology, Alexandroupolis, Greece
| | - C Venetis
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - D Georgantzis
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - V Giaslakiotis
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - V Kolovos
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - K Efstathiou
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - M Moschou
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - Ε Κoutsiaris
- Biogonidiaki, Center of Infertility Investigation and Genetic Research, Volos, Greece
| | - M Panopoulou
- Democritus University of Thrace, Department of Microbiology, Alexandroupolis, Greece
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Kaya D, Demirezen Ş, Hasçelik G, Gülmez Kıvanç D, Beksaç MS. Comparison of PCR, culturing and Pap smear microscopy for accurate diagnosis of genital Actinomyces. J Med Microbiol 2013; 62:727-733. [PMID: 23378560 DOI: 10.1099/jmm.0.053165-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Members of the genus Actinomyces, Gram-positive, non-spore-forming anaerobic bacteria, are normal inhabitants of the mucosal surfaces of the oral, gastrointestinal and genital tracts. Identification of these bacteria using conventional methods is generally difficult because of their complex transport and growth requirements and their fastidious and slow-growing nature. However, in recent years, the advancement of molecular techniques has provided much improved identification and differentiation of closely related Actinomyces species. The aim of the present study was to evaluate the efficacy of the PCR technique in the diagnosis of genital Actinomyces in comparison with culturing and Papanicolaou (Pap) smear microscopy. Multiple sampling was conducted from 200 women using smear microscopy, culturing and PCR. Cyto-brushes were smeared on glass slides and stained using the routine Pap technique. Culturing was performed from a sterile swab, and Actinomyces were determined using the BBL Crystal ANR ID kit. PCR was performed from a second swab, and the Actinomyces type was determined using type-specific primers designed in our laboratory. Only one vaginal fluid sample (0.5%) revealed Actinomyces-like organisms on Pap smear examination. Actinomyces were detected in nine samples (4.5%) using the BBL Crystal ANR ID kit. Using PCR, eight samples (4%) were found positive for Actinomyces. No specimens that gave positive results by Pap smear microscopy and culturing could be confirmed by PCR. Pap smear microscopy and culturing were both found to have zero sensitivity for Actinomyces. PCR appears to be a sensitive and reliable diagnostic method for the detection of Actinomyces, which are difficult to cultivate from genital samples. PCR can be used for diagnostic confirmation in cases diagnosed by conventional methods, to prevent false-positive results.
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Affiliation(s)
- Dilek Kaya
- Hacettepe University, Faculty of Science, Department of Biology, 06800 Beytepe, Ankara, Turkey
| | - Şayeste Demirezen
- Hacettepe University, Faculty of Science, Department of Biology, 06800 Beytepe, Ankara, Turkey
| | - Gülşen Hasçelik
- Hacettepe University, Faculty of Medicine, Department of Medical Microbiology, 06100 Sıhhiye, Ankara, Turkey
| | - Dolunay Gülmez Kıvanç
- Hacettepe University, Faculty of Medicine, Department of Medical Microbiology, 06100 Sıhhiye, Ankara, Turkey
| | - Mehmet Sinan Beksaç
- Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, 06100 Sıhhiye, Ankara, Turkey
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10
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Role of Mycoplasma and ureaplasma species in female lower genital tract infections. Curr Infect Dis Rep 2011; 12:417-22. [PMID: 21308549 DOI: 10.1007/s11908-010-0136-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Genital mycoplasmas are commonly found in the female genital tract. Despite ongoing debate, the evidence that they cause lower genital tract disease in women remains sparse. The data that Mycoplasma genitalium is primarily transmitted sexually are accumulating, but its role as a cause of symptomatic urethritis or cervicitis is open to debate. Although Mycoplasma hominis may be a co-factor in bacterial vaginosis, it has otherwise not been implicated as a cause of lower tract disease. Now that Ureaplasma urealyticum has been divided into U. urealyticum and Ureaplasma parvum, their role in causing urethritis and cervicitis remains even more unclear. To date, no convincing evidence exists that antimicrobial therapy should be directed solely at these organisms when treating women with urethritis, bacterial vaginosis, trichomoniasis, or cervicitis.
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Rakhmatulina MR, Kasatkina IS. The role of Genital Mycoplasmas for the development of urogenital pathology in children. VESTNIK DERMATOLOGII I VENEROLOGII 2011. [DOI: 10.25208/vdv922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Modern data of the epidemiological aspects and clinical peculiarities of inflammatory urogenital diseases caused by genital mycoplasmas in children are represented. Contemporary methods of laboratory diagnostics and therapy for inflammatory urogenital diseases caused by genital mycoplasmas are described.
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Koshiba H, Koshiba A, Daimon Y, Noguchi T, Iwasaku K, Kitawaki J. Hematoma and abscess formation caused by Mycoplasma hominis following cesarean section. Int J Womens Health 2011; 3:15-8. [PMID: 21339933 PMCID: PMC3039004 DOI: 10.2147/ijwh.s16703] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Indexed: 11/26/2022] Open
Abstract
Mycoplasma species cannot be identified by routine bacteriological culture methods and are resistant to common antimicrobial agents. Mycoplasma hominis usually colonizes the lower urogenital tract and causes pyelonephritis, pelvic inflammatory disease, chorioamnionitis, rupture of fetal membranes, preterm labor, postpartum fever, postabortal fever, and neonatal infection. This organism is highly prevalent in cervicovaginal cultures of sexually active women. M. hominis, M. genitalis, Ureaplasma urealyticum, and U. parvum may invade and infect placental and fetal tissues, leading to adverse pregnancy outcomes. M. hominis occasionally causes nongenitourinary infection of the blood, wounds, central nervous system, joints, or respiratory tract. We present a case of a 27-year-old woman who developed abdominal wound hematoma and abscess after cesarean section. The wound was drained, but her high fever persisted, in spite of antibiotic treatment using flomoxef sodium and imipenem·cilastatin sodium. Because the exudate exhibited M. hominis growth in an anaerobic environment, we administered the quinolone ciprofloxacin. This therapy resolved her fever, and her white blood cell count and C-reactive protein level diminished to the normal ranges. To our knowledge, there are four published articles regarding the isolation of M. hominis from postcesarean incisions. Based on the current study and the literature, infection by this pathogen may cause hematoma formation with or without abscess after cesarean section or in immunosuppressed postoperative patients. In such cases, physicians may need to suspect Mycoplasma infection and initiate appropriate antibacterial treatment as soon as possible in order to avoid persistent fever.
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Affiliation(s)
- Hisato Koshiba
- Department of Obstetrics and Gynecology, Kyoto Prefectural Yosanoumi Hospital, Kyoto, Japan
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Yamaguchi M, Kikuchi A, Ohkusu K, Akashi M, Sasahara J, Takakuwa K, Tanaka K. Abscess formation due to Mycoplasma hominis infection after cesarean section. J Obstet Gynaecol Res 2009; 35:593-6. [PMID: 19527408 DOI: 10.1111/j.1447-0756.2008.00993.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 27-year-old female patient underwent cesarean section and a postoperative hematoma occurred at the site of the uterine incision. The patient underwent relaparotomy to remove the hematoma. Four days later she developed a fever of over 39 degrees C and an abscess had formed at the site. Despite therapy with several antimicrobial agents, her fever persisted. Consequently, she underwent transvaginal abscess drainage, after which she promptly became afebrile. Mycoplasma hominis was considered to be the primary causative organism. There are two reasons that could explain why the wound infection became serious: (i) M. hominis is resistant to several antimicrobial agents that are usually used to treat obstetric infections; and (ii) a long time is required to identify the pathogen. In conclusion, M. hominis should be considered as a causative organism if an antimicrobial-resistant infection occurs at the surgical site after a cesarean section.
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Affiliation(s)
- Masayuki Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
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